Rapid blood-pressure lowering in patients with acute intracerebral hemorrhage

Simple item page
dc.contributor.authorAnderson, Craig
dc.contributor.authorHeeley, Emma
dc.contributor.authorHuang, Yining
dc.contributor.authorWang, Jiguang
dc.contributor.authorStapf, Christian
dc.contributor.authorDelcourt, Candice
dc.contributor.authorLindley, Richard
dc.contributor.authorRobinson, Thompson
dc.contributor.authorLavados, Pablo
dc.contributor.authorNeal, Bruce
dc.contributor.authorHata, Jun
dc.contributor.authorArima, Hisatomi
dc.contributor.authorParsons, Mark
dc.contributor.authorLi, Yuechun
dc.contributor.authorWang, Jinchao
dc.contributor.authorHeritier, Stephane
dc.contributor.authorLi, Qiang
dc.contributor.authorWoodward, Mark
dc.contributor.authorSimes, John
dc.contributor.authorDavis, Stephen
dc.contributor.authorChalmers, John
dc.date.accessioned2017-04-10T14:56:02Z
dc.date.available2017-04-10T14:56:02Z
dc.date.issued2013
dc.description.abstractBACKGROUND: Whether rapid lowering of elevated blood pressure would improve the outcome in patients with intracerebral hemorrhage is not known. METHODS: We randomly assigned 2839 patients who had had a spontaneous intracerebral hemorrhage within the previous 6 hours and who had elevated systolic blood pressure to receive intensive treatment to lower their blood pressure (with a target systolic level of <140 mm Hg within 1 hour) or guideline-recommended treatment (with a target systolic level of <180 mm Hg) with the use of agents of the physician's choosing. The primary outcome was death or major disability, which was defined as a score of 3 to 6 on the modified Rankin scale (in which a score of 0 indicates no symptoms, a score of 5 indicates severe disability, and a score of 6 indicates death) at 90 days. A prespecified ordinal analysis of the modified Rankin score was also performed. The rate of serious adverse events was compared between the two groups. RESULTS: Among the 2794 participants for whom the primary outcome could be determined, 719 of 1382 participants (52.0%) receiving intensive treatment, as compared with 785 of 1412 (55.6%) receiving guideline-recommended treatment, had a primary outcome event (odds ratio with intensive treatment, 0.87; 95% confidence interval [CI], 0.75 to 1.01; P=0.06). The ordinal analysis showed significantly lower modified Rankin scores with intensive treatment (odds ratio for greater disability, 0.87; 95% CI, 0.77 to 1.00; P=0.04). Mortality was 11.9% in the group receiving intensive treatment and 12.0% in the group receiving guideline-recommended treatment. Nonfatal serious adverse events occurred in 23.3% and 23.6% of the patients in the two groups, respectively. CONCLUSIONS: In patients with intracerebral hemorrhage, intensive lowering of blood pressure did not result in a significant reduction in the rate of the primary outcome of death or severe disability. An ordinal analysis of modified Rankin scores indicated improved functional outcomes with intensive lowering of blood pressure. (Funded by the National Health and Medical Research Council of Australia; INTERACT2 ClinicalTrials.gov number, NCT00716079.).
dc.format.extent11
dc.identifier.citationThe New England Journal of Medicine, 2013, 368(25):2355-65
dc.identifier.urihttp://hdl.handle.net/11447/1122
dc.identifier.urihttp://dx.doi.org/10.1056/NEJMoa1214609
dc.language.isoen_US
dc.publisherMassachusetts Medical Society
dc.subjectAntihypertensive Agents/therapeutic use
dc.subjectCerebral Hemorrhage/complications
dc.subjectHypertension/drug therapy
dc.titleRapid blood-pressure lowering in patients with acute intracerebral hemorrhage
dc.typeArtículo

Files

Original bundle
Now showing 1 - 1 of 1
Thumbnail Image
Name:
Rapid Blood-Pressure Lowering in Patients(2).pdf
Size:
491.78 KB
Format:
Adobe Portable Document Format
Description:
Texto completo
Download

Collections

Artículos Medicina y Ciencias de la Salud

Implementado por OpenGeek Services